Northern Uganda – Judith Abur, 67 years, a caretaker from Omoro district says her son has been battling with mental illness since 2003.
His condition started mysteriously way and was advised to first visit a traditional healer to establish the cause of his illness. Upon visiting the witch doctor, it was said the son was bewitched by a relative.
“I recall having wasted money to pay the witch doctor yet there is nothing he did to change the condition”, she says.
Being a Christian, she doesn’t understand how she was convinced to go to the witch doctor for such help. However later and due to much worry and stress she decided to be taken to church which didn’t heal. Because of the long distance to the health facility, she had to struggle till she reached the facility and sought better treatment as required by doctors.
A 35-year-old Walter Canogura from the Gulu district says he became mentally ill after he went to the forest to clear their ancestral land and didn’t know that part of the land had spirits. Immediately when he started cutting big trees he suddenly felt a very cold wind blowing over his body and he knew there was something wrong though he continued, after a few minutes he started seeing blurred images as well as losing his senses.
Later he started feeling general weakness all over his body after struggling to reach home, where his family members saw his aggressiveness, beating people and tearing clothes. A pastor was called to pray on him and that’s how he got to sense and found people surrounding him and his hands tied.
“I really cannot tell what happened. I asked why there was a crowd around me and up to now though it still disturbs me. However, I am taking drugs for my well-being and that has given some relief,” Canogura said.
“It has been so terrifying as I imagine battling with the disease. I thank God for having restored my health,” Canogura, a patient in Gulu.
Denis Ojok, a caretaker in Kitgum district, says before he became a Christian, evil spirits used to haunt his son who had been a soldier and fought several wars in Kitgum district.
He recalled a time when his son locked himself inside his house until they had to break in and take him to church for prayers. This helped his son to heal.
So they believe that the only easiest way is by seeking care from church leaders and local healers since health facility is far away and could cost them money.
One a traditional healer reported that he had healed a woman who became spiritually possessed and went mad.
Mental health is the ability of an individual to manage the daily stresses of life and live well with others and make a positive contribution to the society or the community where they live while mental illness is the inability an individual really cope with the normal stresses of life that they go through stresses in life every day, so a person who has mental illness have that inability to cope with the normal stresses in life.
It entails many things, including the ability to think critically, address problems, and live in harmony with other people in the community.
Alfred Droti, Senior Psychiatric Clinical Officer Mental Health Unit Department at Gulu Regional Referral Hospital, says mental health is a global challenge, not only afflicting Uganda. However, he says mental health should be given, priority including a proper budget to eliminate it.
According to Droti, the major factor that accounts for mental health in the region high consumption of alcohol and drugs.
The region is also suffering from the effects of civil war that exposed fighters and families to traumatic situations such as violent killings of relatives, which affected many households. The situation has been made worse by Covid-19.
“Covid-19 and the hard economic situation caused a lot of stress to many, leading to depression and mental health challenges,” he said.
Freddy Odong, a psychologist, says many people still associate mental illnesses with witchcraft and demonic attacks and therefore resort to the cure through culture or prayers.
Some people still prefer traditional healers even when they know that experts from hospitals are there for such conditions of people suffering from mental illness which contributes to relapses, he adds.
He further says mental health challenges are treatable though some of the family members of mentally ill patients tend to seek referral late which poses threats to their recoveries.
Local perspective on mental illness
He says there is also a need to understand why those suffering from mental health resort to traditional medicine to manage the condition.
“It is difficult for people to understand the cause of mental illness and for the locals, the easiest explanation is witchcraft,” he says.
So in many African communities, when someone shows signs of mental illness, the family looks around and consults elders for some explanation, and often, it will be about some ritual not performed which is perceived to have annoyed the ancestors. Consequently, the people resort to traditional healers to deal with the problem.
He says the first point of call is for the traditional healer to provide treatment and when that fails, they seek help from the church and lastly the hospital.
Another issue that families of those suffering from mental health have to worry about is stigma, which prevents them from opening up and seeking help.
Stigma, misconception, and traditional beliefs hamper access to mental treatment.
Odong also says incidents such as post-traumatic stress disorder and gender-based violence which are rampant in Northern Uganda also contribute to high cases of mental health in that region.
Substance and alcohol abuse have also contributed to the problem.
He further says the common mental health problem in the area is depression, a condition whereby one loses interest in eating and working and cannot sleep.
How it is managed:-
Mental health problem requires a multidisciplinary approach to management such as bio-psychosocial, social, and spiritual.
Gulu Referral Hospital registered the admission of 54 percent of males ranging from age 20 to 50 years and females aged ranging from 18 to 45 years at 46 percent suffering from mental illness with 30 to 80 patients presenting the sign in the Out-Patient Department visiting the hospital on a weekly basis.
According to the report, in the last 2 years statistics showed that the hospital registered 8,000 in the Out-Patient Department and those admitted were 450 In-patients with severe forms of mental illness with mood disorder leading by followed by substance abuse.
The only drug at the facility that is provided to a patient suffering from mental illness as a result of alcohol disorder is normally treated with Naltrexone drug which costs UGS 650,000, a price beyond the reach of many people.
However, in 2020, the hospital received 9,061 patients with different mental health conditions as a number of them were still being seen on the street battling the illnesses during the COVID-19 pandemic.
Gulu Regional Referral Hospital serves the entire Acholi Sub-region, Lango, and partly from South Sudanese nationals that add to the rising cases of patients seeking treatment for mental illness as experts attribute mental illnesses to war and poverty in Northern Uganda.
A report from the World Health Organization (WHO) says more than one billion people worldwide are living with a form of mental problem which ranks Uganda as number six in the world suffering from mental health burden whereby 35 percent of Ugandans from mental illness.